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Background: Cancer is today one of the most common public health diseases and the cause of around 9 million deaths each year. Cancer does not only affect the patient with the diagnosis, but also familymembers of the patient due to the occurrence of imbalance within the family system that the diseaseleads to. Family caregivers are thus affected by this imbalance and often take a great deal of responsibility for the care of the cancer patient. Aim: To describe family caregivers’ experiences of giving care to a patient with cancer. Method: General literature review with 10 articles being analyzed using content analysis. Results: Tree main categories emerged. Duty and increased burden, worsening health and need forsupport & information. Results show that family caregivers of cancer patients experience a range of emotional burdens, as well as feelings of inadequacy when caring for a patient with cancer. Conclusion: Family caregivers’ experiences of support and burdens can differ among each other oraffect their quality of life differently. The experiences may vary depending on factors such as type of cancer and stage, support structures, healthcare availability and financial resources within a country. There’s a need for more research on family caregivers’ experiences in relation to differences in those areas. Research in these areas could extend a nurse’s awareness, thus contributing to improved treatment and care.

Syftet med denna studie var att undersöka anhörigkonsulenters erfarenheter av arbetet med anhörigstöd samt upplevelsen av samverkansprocesser med andra aktörer. Studien gjordes med en kvalitativ ansats där empirin samlades in genom sex semistrukturerade intervjuer med anhörigkonsulenter i olika kommuner i Sverige. Empirin analyserades och sammanställdes genom en tematisk analys. Vidare analyserades resultatet i relation till studiens teoretiska utgångspunkter vilka var det salutogena perspektivet och tillhörande känslan av sammanhang [KASAM] samt strukturella aspekter av samverkan. Resultatet visar att anhörigkonsulenterna upplever anhörigas behov som varierande utifrån deras skilda situationer. Tre övergripande behov uppfattas av anhörigkonsulenterna vilka är ett informationsbehov, behov av nya perspektiv och behov av att sätta sig själv i fokus. Resultatet visar att anhörigkonsulenterna upplever att de arbetar med ett individuellt utformat stöd för att möta anhörigas stödbehov men att arbetet görs inom vissa fastställda ramar. Det finns generellt tre insatser som erbjuds anhöriga vilka är individuella samtal, gruppsamtal och aktiviteter av olika slag. Några kommuner erbjuder även andra insatser vilket tyder på att stödet till anhöriga varierar mellan olika kommuner. Anhörigkonsulenterna upplever samverkan som individberoende men som en stor och viktig del av arbetet, dels för att nå ut till anhöriga, dels för att implementera anhörigperspektivet internt inom kommunerna. / This study seeks to explore caregiver consultants' experiences in providing assistance for relative caregivers and their views of collaboration process with other actors. The study adopted a qualitative approach with empirical data gathered from six semi-structured interviews with caregiver consultants in various municipalities throughout Sweden. The empirical data were analyzed and compiled using thematic analysis. Furthermore, the results were analyzed in relation to the study's theoretical framework, which encompassed the salutogenic perspective and the sense of coherence [SOC], along with structural aspects of collaboration. The study's findings indicate that caregiver consultants perceive the needs of relative caregivers as varied, depending on the specific situations of the caregivers. Three overarching needs were identified by the caregiver consultants: an informational need, a need for new perspectives, and a need to prioritize oneself. The results show that the caregiver consultant works with an individually formed support to meet the family caregiver needs, even if the support is predefined within certain boundaries. Generally, three types of support are offered to family caregivers, namely individual sessions, group sessions, and various activities. Some municipalities also offer additional support, suggesting variations in support for relative caregivers across different regions. Caregiver consultants regard collaboration as individual dependence but a significant and integral part of their work, both for reaching out to relative caregivers and for embedding the caregiver perspective internally within municipalities

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Social impairments characteristic of Autism Spectrum Disorder (ASD) are evident in early childhood and often worsen as an individual matures (Rao, Beidel, and Murray, 2008). Despite the emphasis on early intervention and caregiver training, few evidence-based interventions explicitly address the development of social skills in preschool-aged children with ASD (DeRosier, Swick, Davis, McMillen, and Matthews, 2011; Reichow and Volkmar, 2010) and none appear to actively integrate caregivers into treatment (Reichow, Steiner, and Volkmar, 2012). Research indicates that generalization beyond a social skills group setting might occur by including caregivers (DeRosier et al., 2011). The PEERS® program is an evidence-based caregiver-assisted social skills program for adolescents and young adults (Laugeson and Frankel, 2010) that has recently been extended for preschoolers with ASD. An initial randomized controlled trial (RCT) indicated benefits from the PEERS® for Preschoolers (P4P) program, but did not examine caregiver or family outcomes. Researchers also suggest a bidirectional effect in which the family system is impacted by the child with ASD and in turn, the child with ASD is also affected by the family (Karst and Van Hecke, 2012). This study examined the P4P curriculum with 15 children with ASD and their caregivers and examined feasibility of the intervention as well as child social skills, caregiver competency, confidence, and parenting skills in working with their child, and family functioning in the context of the P4P intervention. Results suggest the feasibility of proof concept of applying the P4P curriculum to young children with ASD and their caregivers. Specifically, this 16-session intervention appears to improve social skills scores in children with ASD, which is maintained 4-6 weeks after treatment, increased scores were noted in caregiver confidence interacting with their children, as well as improved scores in their affect/animation and achievement orientation in interaction styles with their child, and noted improvements in their parenting styles overall score. Therefore, this intervention may have an impact both the child and caregiver in positive ways and these positive results are largely maintained at a follow-up after intervention completion. Future research will need to focus more on the entire family unit, as no changes were noted in the present study, and should examine the specific mechanisms that lead to these positive results regarding child social skills and caregiver interaction styles and confidence. Additionally, more work that adds to making P4P an evidence-based treatment must be at the forefront of future work. / Doctor of Philosophy / Social difficulties (e.g., initiating and/or maintaining social interactions, using and/or interpreting verbal and nonverbal social communication, such as eye contact or gestures, understanding others' thoughts and emotions) characteristic of Autism Spectrum Disorder (ASD) are evident in early childhood and often worsen as an individual matures (Baron-Cohen and Wheelwright, 2004; Frith, 2004; Rao, Beidel, and Murray, 2008). Despite the emphasis on early intervention or treatment for individuals with ASD and caregiver (e.g., parent, grandparent, etc.) training, few evidence-based interventions exist that purposefully address the development of social skills in preschool-aged children (DeRosier, Swick, Davis, McMillen, and Matthews, 2011; Reichow and Volkmar, 2010) and none appear to actively involve caregivers in treatment (Reichow, Steiner, and Volkmar, 2012). Research indicates that generalization beyond a social skills group setting might occur by including caregivers (DeRosier et al., 2011). The PEERS® program is an evidence-based caregiver-assisted social skills program for adolescents and young adults (Laugeson and Frankel, 2010) that has recently been extended for preschoolers with ASD. An initial randomized controlled trial (RCT) indicated benefits from the PEERS® for Preschoolers (P4P) program, but did not examine caregiver or family outcomes. Researchers also suggest that there is often an effect on the entire family unit of a child with ASD, which in turn has an impact on the child with ASD (Karst and Van Hecke, 2012). This study examined the P4P curriculum with 15 children with ASD and their caregivers, and examined feasibility of the intervention as well as child social skills, caregiver competency, confidence, and parenting skills in interacting with their child, and family functioning in the context of the P4P intervention. Results suggest that this 16-session intervention appears to improve social skills scores in children with ASD, and these improved scores are largely maintained 4-6 weeks after treatment. Increased scores were also noted in caregiver confidence in interacting with their children as well as in their affect/animation and achievement orientation in interaction styles, and may also improve their parenting style scores overall. Therefore, this intervention may have an impact on both the child and caregiver in positive ways. Future research should address the entire family unit, as no changes were noted in the present study, and should also examine the specific factors that lead to these positive results, as further research adds to P4P becoming an evidence-based treatment.

Bakgrund: Vårdnadsbelastning och stress är vanligt bland anhörigvårdare till personer med demens eller långvarig sjukdom. Minfulness-Based Stress Reduction (MBSR) är en tänkbar fysioterapeutisk intervention för denna grupp. Syfte: Att genomföra en systematisk litteraturstudie i syfte att kartlägga effekt, risk för snedvridning och tillförlitlighet med MBSR som behandlingsmetod för stress och vårdnadsbelastning för anhörigvårdgivare. Metod: En systematisk litteraturöversikt av randomiserade kontrollerade studier genomfördes i databaserna PubMed och PsychInfo. TestEx användes för att bedöma kvaliteten av de utvalda artiklar och tillförlitligheten granskades med granskningsmallen Bedömning av den sammanvägda tillförlitligheten i systematiska översikter. Resultat: Åtta artiklar inkluderades i denna studie och deltagarna var alla anhörigvårdgivare till vuxna personer med långvarig sjukdom. Sju undersökte vårdnadsbelastning och fem undersökte stress. Ingen signifikant skillnad observerades på vårdnadsbelastning. Stress minskades signifikant i tre av fem studier. Kvalitetsgranskning med TextEx resulterade i fyra artiklar med hög kvalitet och fyra med låg. Av de fyra med hög kvalitet gick två att sammanväga för tillförlighet, men dessa bedömdes ha mycket låg tillförlighet. Konklusion: Resultatet baseras på två studier som kunde sammanvägas med kontrollgruppen “ingen behandling”. Dessa visade mycket låg tillförlitlighet för att MBSR hade effekt på stress och vårdnadsbelastning. / Objective: Caregiver burden and stress are common challenges faced by family caregivers of individuals with dementia or chronic illness. Additionally, Mindfulness-Based Stress Reduction (MBSR) is a potential physiotherapeutic intervention for this group. Aim: To assess the effectiveness, risk of bias, and reliability of MBSR as a method of treatment for stress and caregiver burden among informal caregivers. Method: A systematic literature review of randomized controlled trials was conducted using the databases PubMed and PsychInfo. TestEx was used to assess the quality of the chosen studies, and reliability was evaluated using the template to assess the reliability of the results. Results: Eight articles were included in this study and the participants were informal caregivers to adults with chronic illness. Seven investigated caregiver burden, while five examined stress. No significant difference was observed in caregiver burden. However, stress was significantly reduced in three out of five studies. The quality assessment using TestEx resulted in four articles being classified as high quality, and four as low quality. Among the high-quality articles, two could be combined for reliability assessment, but they were deemed to have very low reliability. Conclusion: The results are based on two studies that could be combined with the control group “no treatment”. These studies showed very low reliability regarding MBSR as a treatment of stress and caregiver burden for informal caregivers.

In South Africa, alternative care solutions such as foster homes, child-headed households, placements with relatives and Child and Youth Care Centres (CYCCs), are under pressure to provide for the large numbers of children who need care. Child and Youth Care Centres include facilities such as children’s homes, places of safety, secure care facilities and schools of industry or reform schools. South African legislation offers guidelines towards the fulfilment of children’s needs in CYCCs by providing them with Children’s rights. Unfortunately, not only is literature on children living in CYCCs limited both internationally and locally, existing literature regarding children’s care in CYCCs in South Africa points towards a gap between legislative guidelines and practice of care provision. For example, apparently, children in CYCCs are not afforded opportunities to voice their opinions, and many CYCCs in South Africa are not legally registered. As a result, an obvious indication of the care and interaction taking place between caregivers and children in CYCCs is not available. This inductive, qualitative study aimed to explore and describe the views of children living in Child and Youth Care Centres in the Vaal Triangle area, Gauteng, South Africa, in an effort to gain a better understanding of children’s perceptions of their interactions with their caregivers. One-on-one interviews with children from three CYCCs were conducted. Interviews were voice-recorded and later transcribed. While being interviewed, participants were asked to take part in a role-play exercise and to make a collage of their interaction and relationship with their caregivers. Data was analysed using Creswell’s spiral of analysis and Thematic Analysis by Braun and Clarke. The findings revealed four themes, which encompassed the perceptions of interactions with caregiver: 1. Daily activity with caregiver; 2. Special time with caregiver; 3. Behaviour management strategies; and, 4. Relationship with caregiver. The key findings indicate the valuable insight that was gained by affording children in CYCCs the opportunity to voice their perceptions on their interactions with their caregivers. This not only empowers children and fulfils their right to be heard, but also provides a better understanding of whether needs are being met or not. / MA (Psychology), North-West University, Potchefstroom Campus, 2015